Abstract:
BACKGROUND:Isothiazolinones are preservatives which are present in cosmetics, household chemicals and many other industrial products. Initially, a mixture of methylchloroisothiazolinone and methylisothiazolinone (MCI/MI - Kathon CG) was used, and then, from the beginning of the 21st century, only methylisothiazolinone. Due to a significant increase in the number of contact dermatitis caused by allergy to this compound, it was withdrawn from leave-on cosmetics, and its concentration in rinse-off cosmetics was reduced. The aim of the study was to analyze the incidence of contact allergy to isothiazolinones among patients in the Nofer Institute of Occupational Medicine, Łódź, the intensification of patch test results and hypersensitivity depending on the occupation, and to assess the contribution of immediate allergy to the occurrence of that hypersensitivity. MATERIAL AND METHODS:In a group of 1137 patients (832 females and 305 males) with suspected contact dermatitis, diagnosed in 2014-2018, patch tests series including methylchloroisothiazolinone/methylisothiazolinone (0.01%) and methylisothiazolinone (0.2%), produced by Chemotechnique Diagnostics, Sweden, were performed. In a group of 29 individuals with contact allergy to isothiazolinones, prick tests with methylisothiazolinone (0.001%, 0.01%, 0.1%, 1%) (Sigma-Aldrich, Germany) were conducted. RESULTS:Of the 1137 subjects, 95 (8.3%) were allergic to isothiazolinones, slightly more often females - 71 (8.5%) than males - 24 (7.9%). In total, 150 positive patch tests with isothiazolinones (13.2%) were obtained. The number of positive results with methylisothiazolinone alone (7.8%) was higher than the number with methylisothiazolinone from Kathon CG (5.4%). Among the subjects sensitized to methylisothiazolinone alone strongly positive patch tests (+++) concerned 60.7%. In the female group, office workers (42.3%) and medical staff (18.3%) predominated, and in the male group - locksmiths, turners, mechanics and similar ones (45.8%), and construction workers (25.0%). Prick tests with methylisothiazolinone were negative, and they became positive after 3-5 h. CONCLUSIONS:Isothiazolinones, particularly methylisothiazolinone, are significant causal factors of contact allergy, including that of occupational origin. They have strongly allergenic properties, and in patch tests they often give very severe inflammatory reactions. The issue of the role of immediate allergy in the pathogenesis of isothiazolinones sensitization requires further research. Med Pr. 2020;71(5):603-11. WSTĘP:Izotiazolinony to środki konserwujące, które wchodzą w skład kosmetyków, artykułów chemii gospodarczej oraz wielu produktów przemysłowych. Początkowo stosowano mieszaninę metylochloroizotiazolinonu i metyloizotiazolinonu (MCI/MI – Kathon CG), a następnie – od początków XXI w. – wyłącznie metyloizotiazolinon (MI). Ze względu na znaczący wzrost liczby kontaktowego zapalenia skóry spowodowanego alergią na ten związek wycofano go z kosmetyków pozostawianych na skórze (leave-on) oraz zmniejszono stężenie w kosmetykach zmywalnych (rinse-off). Celem pracy była analiza częstości występowania alergii kontaktowej na izotiazolinony u pacjentów Instytutu Medycyny Pracy im. prof. J. Nofera w Łodzi, nasilenia wyników testów płatkowych, nadwrażliwości w zależności od stanowisk pracy oraz ocena udziału alergii natychmiastowej w powstawaniu uczulenia. MATERIAŁ I METODY:U 1137 chorych (832 kobiet i 305 mężczyzn) z podejrzeniem kontaktowego zapalenia skóry, diagnozowanych w latach 2014–2018, przeprowadzono serię testów płatkowych, zawierających m.in. metylochlorotiazolinon/metyloizotiazolinon (0,01%) oraz metyloizotiazolinon (0,2%) (Chemotechnique Diagnostics, Szwecja). U 29 chorych uczulonych kontaktowo na izotiazolinony wykonano punktowe testy skórne z metyloizotiazolinonem (0,001%, 0,01%, 0,1%, 1%) (Sigma-Aldrich, Niemcy). WYNIKI:Wśród 1137 badanych alergię na izotiazolinony potwierdzono u 95 (8,3%) chorych: 71 (8,5%) kobiet i 24 (7,9%) mężczyzn. Uzyskano 150 dodatnich wyników testów płatkowych z izotiazolinonami (13,2%). Liczba dodatnich wyników tylko z metyloizotiazolinonem była wyższa (7,8%) niż z metyloizotiazolinonem pochodzącym z Kathonu CG (5,4%). U osób uczulonych tylko na metyloizotiazolinon silnie dodatnie wyniki testów płatkowych (+++) dotyczyły aż 60,7% badanych. W grupie kobiet przeważały pracownice biurowe (42,3%) i personel medyczny (18,3%), w grupie mężczyzn – zatrudnieni na stanowiskach ślusarzy, tokarzy, mechaników i podobnych (45,8%) oraz pracownicy budowlani (25,0%). Testy punktowe z metyloizotiazolinonem były ujemne, pozytywizowały się po 3–5 godz. WNIOSKI:Izotiazolinony, zwłaszcza metyloizotiazolinon, są istotnymi czynnikami przyczynowymi uczulenia kontaktowego, w tym o pochodzeniu zawodowym. Mają silne właściwości alergizujące, w testach płatkowych dają często bardzo nasilone odczyny zapalne. Zagadnienie udziału alergii natychmiastowej w patogenezie uczulenia na izotiazolinony wymaga dalszych badań. Med. Pr. 2020;71(5):603–611.
journal_name
Med Prjournal_title
Medycyna pracyauthors
Kieć-Świerczyńska M,Nowakowska-Świrta Edoi
10.13075/mp.5893.01037subject
Has Abstractpub_date
2020-09-24 00:00:00pages
603-611issue
5eissn
0465-5893issn
2353-1339pii
125058journal_volume
71pub_type
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